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Journal of Cardiovascular Nursing:
doi: 10.1097/JCN.0000000000000162
Feature Article: PDF Only

Effect of a Transtheoretical Model-Based Stage-Matched Exercise Intervention on Exercise Behavior and Angina in Patients With Coronary Heart Disease: A Randomized Controlled Trial.

Zhu, Li-Xia PhD, RN; Ho, Shuk-Ching PhD, RN; Sit, Janet Wing Hung PhD, RN; He, Hong-Gu PhD, MD, RN

Published Ahead-of-Print
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Abstract

Background: Angina is one of the most common complaints among patients with coronary heart disease (CHD). Evidence has shown that regular exercise is beneficial for angina management. However, poor adherence to exercise prescription may limit its effect on angina symptoms and rehabilitation outcomes. The transtheoretical model (TTM) is an effective model for changing exercise behavior in various populations. However, few studies have examined its effects on changing exercise behavior and angina in patients with CHD.

Objective: This study aimed to examine the effects of a TTM-based stage-matched exercise intervention (SMEI) on exercise behavior and angina in sedentary patients with CHD.

Methods: A randomized controlled trial with repeated-measures design was adopted. A total of 196 patients were recruited and randomly assigned into a conventional group, a patient education group, or an SMEI group, with stratification of their exercise stages of change. Outcome measures included exercise behavior and angina at baseline, immediately after intervention, and at 3- and 6-month follow-up.

Results: Our findings showed that the SMEI group demonstrated more positive shifts in exercise stages of change (P < 0.01) and better improvement in physical limitation (P < 0.01), treatment satisfaction (P < 0.01), and disease perception (P < 0.01) measured by the Seattle Angina Questionnaire than the other 2 groups up to 6-month follow-up periods. No significant differences were found among the 3 groups at each time point in angina stability and angina frequency measured by the Seattle Angina Questionnaire and in the frequency, severity, and duration of anginal attacks according to a logbook kept by the participants.

Conclusions: The TTM-based SMEI has positive effects on patients' exercise behavior and partially positive effects on their angina.

(C) 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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